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Health system criticized in I. Coast model's death

Saturday - 4/12/2014, 10:34am EDT

MARC-ANDRE BOISVERT
Associated Press

ABIDJAN, Ivory Coast (AP) -- Awa Fadiga was attacked at night in a taxi that was taking her home to an upscale neighborhood in Ivory Coast's capital. Two witnesses say they saw the locally famous fashion model being thrown out of the cab under a bridge, apparently unconscious.

Firefighters rushed the 23-year-old to the Central University Hospital where she was left untreated for more than 12 hours and slipped into a coma -- all because there was no one immediately available to pay her medical fees, her family said.

"We found her half-naked on the floor, in a coma. We had to use her grandmother's scarf to hide her breasts," said her aunt Sira Kone Fadiga. The model died two days later.

Fadiga's case has fascinated and angered many here who complain of the decline of Ivory Coast's health care system that once was the envy of West Africa.

"Everybody has a story like that. Awa is just the symbol of all our pain," said Salif Barry, a 23-year-old technology worker. "It is a moment to come together and ask ourselves what has become of our health care system." More than 8,000 Ivorians signed an online petition criticizing the hospital's behavior in Fadiga's case and 21,000 have joined a Facebook group denouncing "the priority of money over basic health care."

The hospital has denied claims of negligence, saying officials were following standard procedure, but the director of the hospital was fired on Friday.

The hospital, in a large concrete building erected in the 1960s at Ivory Coast's largest university in Abidjan's Cocody district, is a symbol of what Ivorians describe as freefalling care standards. It used to be considered the most modern hospital in West Africa.

Once one of Africa's most prosperous and stable countries, Ivory Coast has experienced economic decline and turbulent politics. The country of 20 million people came near to a civil war in early 2011 when Laurent Gbagbo refused to step down from power after losing elections. This sparked a violent crisis in which more than 3,000 people were killed before President Alassane Ouattara took office.

Free health care was stopped the 1990s because of the country's struggling economy and pressure from global financial institutions. The free care was temporarily reinstated after the postelection violence in 2011, but it proved too expensive and was again abandoned. Ouattara's government has said it intends to re-introduce universal health coverage by 2015.

The state of the Cocody hospital illustrates the decline in Ivory Coast's health services. The hospital has leaking water pipes and there aren't enough beds for patients. Equipment is missing or broken, and doctors say they lack even the most basic resources.

"We have to buy our own soap to wash our hands," said one doctor who spoke on condition of anonymity because he feared losing his job. "We do want to help patients, but we do not have the means to do more. It's sad. When I started working at this hospital as an intern, it gave me pride. Now I realize how, slowly, this hospital is crumbling down."

Ivory Coast's health care troubles hit Awa Fadiga just as her modeling career was starting to take off: She had signed with an elite agency and landed several major gigs, including an advertisement campaign with the telecoms firm Orange.

"Since she was a young teenager, people would stop her in the street to offer her modeling jobs," said her aunt, who had raised her since she was 5 years old. The family heard about her injuries just before 1 p.m. the day after she hailed the cab in March, Kone Fadiga said.

She said the hospital refused to provide even basic care until someone came to pay for Fadiga's treatment, showing bills amounting to around $230 for everything from medicine to sanitary gloves. The hospital CT scan machine was down that day, so Fadiga's family also had to pay for transport to a private clinic, her aunt said.

Fadiga's death was caused by severe head injuries including a skull fracture sustained during the assault, according to the family and medical reports. Attacks in private taxis are fairly common, usually involving the driver and an accomplice who waits at an agreed-upon location to rob an unsuspecting passenger or is sometimes even hiding in the trunk. Police are searching for the driver and have shown two portraits of the alleged aggressors.

Health Ministry officials declined to comment for this story, but they have published several documents about Fadiga's case including a medical report. A statement said the ministry was not responsible for her death.

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